Search This Blog

Respectful Insolence is a repository for the ramblings of the aforementioned pseudonymous surgeon/scientist concerning medicine and quackery, science and pseudoscience, history and pseudohistory, politics, and anything else that interests him (or pushes his buttons). Orac's motto: "A statement of fact cannot be insolent." (OK, maybe it can be just a little bit insolent.)

"Alternative" nutrition takes the life of a baby

I don't have a problem with vegans, although I tend to view veganism as more cultish than anything else. Certainly it's possible for an adult to remain reasonably healthy on a strictly vegan diet, but it's difficult (and, for me, it would be quite unsatisfying). Other than for strictly religious or moral reasons, I could never understand why vegans will not eat dairy products, which will more easily supply certain needed proteins and fats, or even eggs, which, because they are unfertilized, are not the same as killing animals for food. However, live and let live, I usually say. The only people harmed or helped by vegan diets are those who follow them. Given that, such diets are usually personal choices and none of my business. (If only vegans considered my choice to include meats and seafood in my diet in similar terms.)

My understanding and tolerance end, however, when such diets are imposed on children, whose nutritional needs are different from those of adults. For these and other personal reasons (people who know me will know what those reasons are), stories like this just burn me up. It tells the tale of Woyah Andressohn, a 6-month old who died of starvation because the parents were raw food vegans who insisted on subjecting their children to their nutritional choices:

MIAMI (Court TV) — A 6-month-old infant seemed more like a newborn when paramedics found her gasping for air on the floor of her parents' home, an emergency responder testified Tuesday in the manslaughter trial of the child's parents.

Paramedic Fernando Castano told jurors in the case against Joseph and Lamoy Andressohn that he mistook their 7-pound, 22-inch child for a newborn as he attempted to revive her.

Woyah died about 45 minutes later from what a medical examiner later diagnosed as "accidental malnutrition," according to Castano.

By their own admission to police, the couple kept their five children on a strict diet of uncooked organic foods and juices made from wheatgrass, almonds and coconuts.

During a lunch break in Miami-Dade Criminal Court, the couple snacked on nuts and grains wrapped in leaves of kale, with an apple on the side.

The couple faces 50 years in prison on manslaughter and child endangerment charges if convicted.

Also:

The Andressohns are also standing trial on counts related to Woyah's four older siblings, who, like her, were found to be smaller than 99 percent of other children their ages, Walker said.

According to other reports, the parents also administered enemas to their children on a regular basis and would whip the older children if they ate the wrong foods. Moreover, they apparently ignored obvious signs of malnutrition. This baby was half the weight she should have been and, according to the paramedics who responded to the call when she was unresponsive, Woyah was "rail thin" with a distended belly, looking "like something you might see in a National Geographic magazine, in an African country or a Third World country." Any pediatrician who saw the child would have instantly recognized that something was seriously wrong.

I truly can't understand something like this. Leaving aside the question of whether it's possible to raise a healthy child on a vegan diet (many vegans will claim it is), there's an obvious answer for vegan parents who want to raise their children as vegans in the first year of life: breast milk! It's the perfect food for human infants, providing all the nutrition a child needs, as well as immunoglobulins that aid the child in fighting off disease. It's the best diet for the first several months of life, bar none, and then can be used to supplement the baby's diet as solid foods are slowly added. Why on earth couldn't Woyah have been fed with breast milk, if the parents objected to dairy or meat products? Indeed, pro-vegan websites advocate this very strategy, and, once the child is eating solid food, to supplement with breast milk for as long as feasible and to provide various oils in the diet to make up for the lack of fats in a vegan diet. And, if the mother can't produce enough milk, there are soy-based formulas that can be used. As some vegans who have commented on the issue have said, to stay healthy eating a raw food vegan diet requires that you really know what you're doing, particularly with children. It is apparent that the Andressohns did not. It also requires that the child be monitored closely by a pediatrician to make sure that the child is appropriately gaining weight.

People like the Andressohns seem to think that this sort of uncooked vegan diet is somehow more "natural," but in reality it probably is not. Humans are and have been omnivores for a very long time, and the earliest humans were hunter-gatherers, who lived by scavenging dead animals, hunting, and gathering fruits and vegetables. We have evolved over millions of years to get a certain proportion of our calories from meat, a high energy, high protein source of food (exactly what proportion is a subject of debate, of course). Also, raw vegan diets require quite a bit of First World sanitation to be healthy. In the absence of such sanitation and very clean conditions, they can be a vector for food-borne illnesses. That does not mean a vegan diet is not healthy, but it is probably not any more "natural" than a mixture of meat, fruits, and vegetables, the claims of its adherents notwithstanding.

Not surprisingly, the parents are crying persecution and oppression. The defense is also claiming that the child in actuality died of DiGeorge Syndrome, not starvation, based on the finding of no thymus during the autopsy. While I do not dismiss the possibility that this child had DiGeorge Syndrome, the claim sounds unconvincing because the child did not have the other abnormalities that go along with the syndrome, such as congenital heart defects (such as Tetralogy of Fallot or ventricular septal defect), cleft palate, or facial abnormalities. Also, the pathology report demonstrated the presence of T cells, meaning a thymus must have been present, and prosecutors have pointed out that malnutrition can cause the thymus to shrink greatly. In any case, whether or not the defense has a point can be easily shown by a simple genetic test. If Woyah in fact had DiGeorge Syndrome, a simple fluorescence in situ hybridization (FISH) should detect the characteristic microdeletion of chromosome 22 (specifically, del 22q11.2). If the deletion is not there, the child did not have DiGeorge Syndrome. Even if the child did have DiGeorge Syndrome, that would not get the parents off the hook, because this syndrome is not associated with malnutrition and the child would not have been "doomed from birth," as Ellis Rubin, a lawyer for Lamoy Andressohn has claimed.

Also countering this claim of "persecution" is the rather interesting fact that Miami-Dade County Assistant State Prosecutor Herbert Walker is himself a raw food vegan, who is not buying this defense: "A growing child such as baby Woyah needs nutrients to grow. At the end of her life, and a painful life it was, the child had practically lost all her subcutaneous fat and her body was going through auto-cannibalism because she was not getting enough nutrients." He continued: "The question is, did the parents provide the care necessary for the well-being of their five children?"

Comments

I'm not normally given to bloody-minded fantasies but, if these two are indeed found guilty, I think they should be thrown to the wolves...literally. What they did is just despicable in a way that a sane mind can barely even fathom. If they think it's OK to sacrifice their own childrens' lives for the sake of dietary dogma, what more appropriate punishment could there be than to see how those beliefs hold up when different lives (theirs) and dietary choices (the wolves') are in the balance?

Greg: I wondered about that too. If they didn't take supplements they were probably B12 deficient, which can lead to neuropathy as well as anemia. Their other children almost certainly suffer from pernicious anemia unless they have been given supplements and it doesn't sound like the parents were aware enough to supplement, though I hope I'm wrong.

On a lighter note, a random observation from the article Orac quotes: "The boys... told police in interviews that they were fed a steady diet of uncooked organic foods and cleansed with wheatgrass enemas in lieu of attending doctors."

Are attending doctors a usual part of the average diet in Florida or are they the usual content of enemas? Either way, it explains why there's always a shortage of doctors in Florida.

It's the way that all sorts of different things get mixed up to create these weird ideologies. I'm a long-time veggie, and I'm trying to cut down on my use of animal products in general because of cruelty/unsustainability (I know this doesn't apply to all animal products, and a vegetable product shipped half way round the world is worse for the environment than a local animal product). But I don't tend to tell people that. The reason: the assumption is that if you're a veggie/vegan that you're into every sort of altie fad that comes your way, or that you're a militant animal-rights type. I've seen posts on veggie messagebaords where people are describing some quite severe symptoms (severe menhorragia for example), and them being advised to make dietary changes, not 'see a doctor'.

In this sort of atmosphere I can see how these parents came to their conclusions; they would have found encouragement from the 'devoted bretheren' at every turn.

I love meat (including stuff most Americans gag on) way too much to ever consider switching to a vegetarian, even less a vegan diet, and this is completely irrelevant to the issue of nutrition for infants and children, but...

"I could never understand why vegans will not eat dairy products, which will more easily supply certain needed proteins and fats"

I have enough friends, mostly Asian, who would have even more problems with malnutrition on a steady diet of dairy products. Lactose intolerance is the norm for adult mammals, including humans.

Wheatgrass enemas? I remember my first smoothie with wheatgrass in it. It actually tasted pretty good, so I went on the web to see what all the incredible-nutritive-power claims were about. Answer: nothing. I couldn't find so much as an FDA analysis of the stuff. One page touted it for its "high chlorophyll content", as if drinking enough wheatgrass would make you an autotroph.

I'll second mw's mention of cruelty/sustainability issues. Minimizing beef is a cheap (indeed, money-saving) way to reduce my environmental footprint. I'm not a vegetarian, but sustainability issues are a good reason to go down that road.

My mother has gotten into raw food, and some of the things she's been saying about it are really bizzare. I'm still trying to figure out how cooking food makes it inorganic, or what these mysterious toxins cooked food is supposed to have are.

It is a real tragedy that there are people who don't realise that children have different nutritional requirements than adults and that this ignorance can cause death. I don't doubt that they love their children and were doing what they thought was right, but they were obviously wrong. I really wish that people with wacky ideas wouldn't sacrifice their children's well being in order to stick to their belief system.

Anyone following an alternative diet for whatever reason should do thorough research first. (from reputable sources.) To be so ignorant as to not even realize that your child is seriously underweight...? You don't have to be a genius to notice something like that. I agree with anonymous that they seem to have been putting their beliefs before the well-being of their children. If they were not suffering from some form of brain malfunction they are murderers!

There are vegan diets and vegan diets. Abstaining from eggs, dairy, and meat is a far cry from raw foods, enemas, and whippings. Your condemnation of the Andressohns does not differentiate between abstaintion from meat, etc, and subscribtion to wacky theories about raw foods and enemas. It was the latter which led to the infant's death, not the former.

I posted on this case on Steve Gilliard's News Blog. It makes me very sad to see this kind of thing happen. Because at its core these people thought they were doing what was best for their children. They of course were wrong on so many levels that it becomes clear that they were negligent as a matter of law, and therefore deserve any punishment that comes to them.

My exposure to wierd diet things was hanging out with a single vegan girl in college. She was skinny when I met her, but she lost even more wieght on her animal rights fueled quest to rid herself of meat. And I can understand wanting to avoid hurting animal, but I can't understand jeopardizing your health for that purpose.

We are omnivores and any arguement otherwise is foolish. As for milk... well I can drink an entire gallon in an hour without feeling sick (something that is supposedly impossible) so I think that drinking a glass at dinner is not so unnatural for me.

I posted on this case on Steve Gilliard's News Blog. It makes me very sad to see this kind of thing happen. Because at its core these people thought they were doing what was best for their children. They of course were wrong on so many levels that it becomes clear that they were negligent as a matter of law, and therefore deserve any punishment that comes to them.

My exposure to wierd diet things was hanging out with a single vegan girl in college. She was skinny when I met her, but she lost even more wieght on her animal rights fueled quest to rid herself of meat. And I can understand wanting to avoid hurting animal, but I can't understand jeopardizing your health for that purpose.

We are omnivores and any arguement otherwise is foolish. As for milk... well I can drink an entire gallon in an hour without feeling sick (something that is supposedly impossible) so I think that drinking a glass at dinner is not so unnatural for me.

Frito xyx said:"Because at its core these people thought they were doing what was best for their children."That is completely bogus.....you can't possibly convince me that parents are thinking about their kids when they let a child wither away to the size of a newborn--without seeking medical help. Even in the worst case vegan diet scenario, a good parent would question abnormal weight loss and would seek medical help (at which point they'd find out that the diet is causing harm). I think these parents are not guilty of diet issues; they're guilty of neglect by not seeking medical care for a dying child. People get so fanatical about "alternative" agendas and big Pharma conspiracy theories that they lose sight of reality. I call it "altie-induced schizophrenia."

It is these paragraphs where the distinction is blurred: "The only people harmed or helped by vegan diets are those who follow them. Given that, such diets are usually personal choices and none of my business. (snip for brevity) It tells the tale of Woyah Andressohn, a 6-month old who died of starvation because the parents were raw food vegans who insisted on subjecting their children to their nutritional choices."

In the commentary following the court tv quotes, Orac devotes two paragraphs to debunking veganism *without* making any distinction between raw food wackiness and meat/dairy/etc free diets. Veganism does not need debunking. Raw food diets sorely do.

A little late with my comment, but as a more-or-less vegetarian, simply because I don't particularly feel like eating meat (I eat plenty of seafood though), I would point out that tehre might be good medical reasons for avoiding meat. The stuff the animals get feeded - anti-biotics etc. However, if there is a fairly decent control system in your country, this shouldn't be an issue.

When my daughter was born she was allergic to all formulas. I had a problem producing adequate breast milk and I fed her homemade almond milk as an alternative. She thrived during her first year on the breast/almond milk combination (I stopped breast feeding her at 5 months) and now is a healthy 9-year old. We are semi-vegitarians.

The only things I am concerned about with this case is the amount of food the child was allowed to consume and the introduction of wheatgrass. If the baby was fed an adequate amount of almond milk, there should have been no problem. I wouldn't recommend that anyone consume wheatgrass. I find it far too sweet and prone to make the consumer feel terrible.

Orac is but a humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. That Orac has chosen his pseudonym based on a rather cranky and arrogant computer shaped like a clear box of blinking lights from an old British SF show whose special effects were renowned for their early 1980's BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction for television ever produced, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.) Orac tries to keep his insolence respectful, but admittedly sometimes fails in the cases of obvious quackery and pseudoscience, attacks on him, very poor critical thinking skills, bigotry, and just general plain stupidity.